Unifying Concepts

Serum Levels That Differentiate Anemia of Chronic Disease from Iron-Deficiency Anemia

Iron deficiency anemia develops when body stores of iron drop too low to support normal red blood cell (RBC) production. Inadequate dietary iron, impaired iron absorption, bleeding, or loss of body iron in the urine may be the cause.

Variable Anemia of Chronic Disease IronDeficiency Anemia Both Conditions
Iron Reduced Reduced Reduced
Trasnferrin Reduced to normal Increased Reduced
Transferrin saturation Reduced Reduced Reduced
Ferritin Normal to increased Reduced Reduced to normal
Soluble transferrin receptor Normal Increased Normal to increased
Ratio of soluble transferrin receptor to log ferritin Low (<1) High (>2) High (>2)
Cytokine Levels Increased Normal Increased

Patients with both conditions include those with anemia of chronic disease and true iron deficiency.




  1. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005 Mar 10;352(10):1011-23. [Medline]


Created: May 03, 2005

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